Active NPI
Lowell Bruce Davis, DDS, MS
- Periodontics
- Oakland, CA
National Provider Identifier
1114032349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 26049
- Practice address
- 2844 Summit St Ste 202
Oakland, CA 94609-3642 - Phone
- (510) 834-3414
- Fax
- (510) 763-6004
- NPI assigned
- Aug 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 26049 | CA | Primary |
Addresses
Primary practice location
2844 Summit St Ste 202
Oakland, CA 94609-3642
Mailing address
2844 Summit St Ste 202
Oakland, CA 94609-3642
Phone (510) 834-3414
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160425001568 | CA | Practitioner - Oral Surgery | 9436458585 | Practice locations: Livermore, CA; Oakland, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rakhibahen Jani Dental Corporation | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Livermore, CA
- NPI 1275992547
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735516800000",
"number": "1114032349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2844 SUMMIT ST STE 202",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946093642",
"telephone_number": "510-834-3414",
"fax_number": "510-763-6004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2844 SUMMIT ST STE 202",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946093642",
"telephone_number": "510-834-3414",
"fax_number": "510-763-6004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "LOWELL",
"middle_name": "BRUCE",
"name_prefix": "Mr.",
"credential": "DDS, MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-20",
"last_updated": "2024-12-30",
"certification_date": "2020-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CA",
"license": "26049",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.